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New Insights into Arterial Stiffness
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New Insights into Arterial Stiffness

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: closed (20 April 2024) | Viewed by 2770

Special Issue Editor

Dr. Kazuhiro Shimizu

E-Mail Website
Guest Editor
Department of Internal Medicine, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba 285-8741, Japan
Interests: vascular function

Special Issue Information

Dear Colleagues,

Arterial stiffness is a concept that has been developed in the field of epidemiological studies. It is well known that people with increased arterial stiffness have a higher incidence of future cardiovascular disease. The cardio-ankle vascular index (CAVI) was developed as an index of arterial stiffness from the origin of the aorta to the ankle. CAVI is a numerical index of arterial stiffness derived from the stiffness parameter beta theory and the application of the Bramwell–Hill equation for pulse wave velocity (PWV). The main advantage of CAVI is its independency from blood pressure at the time of measurement. By taking advantage of this feature, CAVI makes it possible to study vascular function, which has been difficult with the previously utilized PWV. CAVI, measured at stability, reflects arterial structural stiffness well. On the other hand, CAVI that fluctuates briefly with intervention or invasion is recognized as representing functional arterial stiffness. Changes in arterial stiffness due to various therapeutic interventions and risk exposures is a new expanding research field.

The purpose of this Special Issue is to introduce the possibility of new fields related to vascular function. This Special Issue will bring new inspiration to all of you in your daily clinical practice.

In this Special Issue, we would like to broadly invite reports of studies that focus on vascular function rather than epidemiological studies. Original articles and reviews are welcome. We look forward to receiving your contributions.

Dr. Kazuhiro Shimizu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • arterial stiffness
  • cardio-ankle vascular index
  • vascular function

Published Papers (4 papers)

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Research

12 pages, 1864 KiB  
Article
Role of Vascular Function in the Prognosis of Heart Failure Patients
by Shunsuke Kiuchi, Shinji Hisatake, Shintaro Dobashi, Yoshiki Murakami and Takanori Ikeda
J. Clin. Med. 2024, 13(9), 2719; https://doi.org/10.3390/jcm13092719 - 6 May 2024
Viewed by 430
Abstract
Background: Blood vessels have the Windkessel effect and are involved in blood circulation. The breakdown of this mechanism is also involved in the pathogenesis of heart failure (HF); however, the relationship between vascular dysfunction and HF prognosis is not fully understood. Methods: [...] Read more.
Background: Blood vessels have the Windkessel effect and are involved in blood circulation. The breakdown of this mechanism is also involved in the pathogenesis of heart failure (HF); however, the relationship between vascular dysfunction and HF prognosis is not fully understood. Methods: We evaluated 214 patients hospitalized for HF at our institution who underwent a cardio–ankle vascular index (CAVI), which evaluates vascular function, between January 2012 and July 2018. To investigate factors (including CAVI) associated with major adverse cardiac events (MACE) during 1 year after patients with HF were discharged, we evaluated clinical profiles, blood tests, chest X-P, 12-lead electrocardiography, and transthoracic echocardiographic findings. MACE was defined as cardiovascular death or readmission for HF. Results: The severity of HF between the MACE and non-MACE was not significantly different. Previous HF and chronic kidney disease were significantly more common in the MACE group. CAVI and % mean atrial pressure in the MACE group were statistically higher than those in the non-MACE group. The cardiac shadow as shown by chest X-P and left ventricular size in the MACE group were significantly bigger, and HF preserved ejection fraction (EF) (EF > 50%) was significantly more common in the MACE group. In multivariate analysis, CAVI was an independent predictive factor for the occurrence of MACE (model 1; hazard ratio (HR): 1.33, 95% confidence interval (CI): 1.05–1.68, p = 0.018; model 2; HR: 1.31, 95% CI: 1.07–1.60, p = 0.009). Conclusions: Because high CAVI is associated with poor prognosis of HF, these patients require more careful treatment. Full article
(This article belongs to the Special Issue New Insights into Arterial Stiffness)
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12 pages, 873 KiB  
Article
Preliminary Study on Pulse Wave Changes in Patients with Inflammatory Arthropathies Treated with bDMARDs
by Michela Gasparotto, Giuliano Di Pierro, Barbara Toffoli, Andrea Grillo, Marco Bressan, Marco Fiorentin, Lorenzo Di Luozzo, Fabio Fischetti, Margherita Zen, Bruno Fabris, Stella Bernardi and Paola Tomietto
J. Clin. Med. 2024, 13(9), 2684; https://doi.org/10.3390/jcm13092684 - 2 May 2024
Viewed by 407
Abstract
Background: Patients with inflammatory arthropathies exhibit an increased cardiovascular disease (CVD) risk as compared to the general population, which is not fully quantified by the conventional CVD risk scores. Biotechnological disease-modifying drugs (bDMARDs) have proved beneficial to reduce the overall CVD risk in [...] Read more.
Background: Patients with inflammatory arthropathies exhibit an increased cardiovascular disease (CVD) risk as compared to the general population, which is not fully quantified by the conventional CVD risk scores. Biotechnological disease-modifying drugs (bDMARDs) have proved beneficial to reduce the overall CVD risk in these patients, although CVD remains a major cause of increased mortality. Since it has been shown that pulse wave parameters and in particular carotid–femoral pulse wave velocity (cfPWV) are predictors of CVD risk, the aim of this study was to evaluate their changes in patients with inflammatory arthropathies before and after bDMARD therapy. Methods: Pulse wave parameters were evaluated with applanation tonometry in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA), and rheumatoid arthritis (RA), before and after two years of bDMARD therapy. Results: At baseline, cfPWV was significantly associated with age (p < 0.001) and, among pulse wave parameters, the subendocardial viability ratio was negatively associated with C-reactive protein (CRP) (p = 0.04) and the HAQ-disability index (p = 0.03). At baseline, PsA patients showed a higher percentage of male subjects, higher CRP, and the highest cfPWV values (p = 0.048). After two years, pulse wave parameters improved in the AS and RA groups, but not in the PsA group. Conclusions: Our data confirm that pulse wave parameters are potentially reversible after bDMARD therapy, as they improved in AS and RA patients. In PsA patients, there were no changes, which may be due to the higher percentage of male subjects and higher baseline cfPWV values. Full article
(This article belongs to the Special Issue New Insights into Arterial Stiffness)
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Figure 1

13 pages, 1212 KiB  
Article
Effects of Vildagliptin, a Dipeptidyl Peptidase-4 Inhibitor, on the Parameters of Glucose Metabolism and the Cardio-Ankle Vascular Index in Individuals with Type 2 Diabetes
by Daiji Nagayama, Hidetoshi Kawana, Yasuhiro Watanabe, Osamu Horikawa, Masahiro Ohira and Atsuhito Saiki
J. Clin. Med. 2024, 13(2), 481; https://doi.org/10.3390/jcm13020481 - 15 Jan 2024
Viewed by 966
Abstract
DPP-4 inhibitors are frequently used as first-line agents for the treatment of type 2 diabetes in Japan. This study aimed to examine the effects of vildagliptin on glucose metabolism and arterial stiffness. Twenty treatment-naïve patients with type 2 diabetes (8 males and 12 [...] Read more.
DPP-4 inhibitors are frequently used as first-line agents for the treatment of type 2 diabetes in Japan. This study aimed to examine the effects of vildagliptin on glucose metabolism and arterial stiffness. Twenty treatment-naïve patients with type 2 diabetes (8 males and 12 females) received vildagliptin 50 mg twice daily for 6 months. Self-monitored blood glucose measurements and a 75 g OGTT were performed. Arterial stiffness was assessed using the CAVI. After the vildagliptin treatment, a significant decrease in the median HbA1c (from 8.3 to 6.4%) and fasting HOMA-β (from 26.1 to 34.5%), and a marginally significant decrease in the CAVI (from 8.9 to 8.4, p = 0.087) were observed. The glycemic variability parameters also improved, whereas the insulin sensitivity and oxidative stress remained unchanged. Participants with a lower glycemic variability on the 75 g OGTT after vildagliptin treatment showed a significant decrease in their CAVI. The baseline BMI was significantly higher for the participants with a decreased CAVI than in those with no change in their CAVI (24.5 vs. 20.8 kg/m2). After vildagliptin treatment, a decrease in the CAVI was observed, especially in the individuals with improved glycemic variability on the 75 g OGTT. Vildagliptin may be suitable for vascular protection in individuals with high glycemic variability and/or an elevated BMI. Full article
(This article belongs to the Special Issue New Insights into Arterial Stiffness)
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11 pages, 1034 KiB  
Article
Changes in Arterial Stiffness Monitored Using the Cardio-Ankle Vascular Index in Patients with Rheumatic Disease Receiving Initial Glucocorticoid Therapy: A Clinical Pilot Study
by Kaichi Kaneko, Daiki Sakai, Shuji Sato, Toshio Kinoshita and Kazuhiro Shimizu
J. Clin. Med. 2023, 12(21), 6923; https://doi.org/10.3390/jcm12216923 - 3 Nov 2023
Viewed by 626
Abstract
Systemic inflammatory rheumatic diseases predispose to premature birth, accelerated atherosclerosis, and increased cardiovascular disease (CVD). While glucocorticoids (GCs) are used in various rheumatic diseases, and the associations between GC excess and increased prevalence of CVD complications are well established, the mechanisms underlying GCs’ [...] Read more.
Systemic inflammatory rheumatic diseases predispose to premature birth, accelerated atherosclerosis, and increased cardiovascular disease (CVD). While glucocorticoids (GCs) are used in various rheumatic diseases, and the associations between GC excess and increased prevalence of CVD complications are well established, the mechanisms underlying GCs’ role in atheroma development are unclear. We conducted an observational study to address GC therapy’s effect on arterial stiffness using the cardio-ankle vascular index (CAVI) in patients with rheumatic diseases. Twenty-eight patients with rheumatic disease received initial GC therapy with prednisolone at doses ranging from 20 to 60 mg/d. CAVI was examined at baseline and 3 and 6 months after GC therapy. Changes in CAVI and inflammatory parameters were evaluated. GC therapy increased the mean CAVI after 3 months but decreased it to pretreatment levels after 6 months. The mean CAVI substantially decreased with GC treatment in patients <65 years but increased in patients ≥65 years. Alterations in CAVI during the 6-month GC treatment negatively correlated with the lymphocyte-to-monocyte ratio (LMR) at baseline. Conversely, no correlation was observed between alterations in CAVI values and conventional inflammatory markers (C-reactive protein and erythrocyte sedimentation rate). Multivariate analysis of factors related to changes in CAVI highlighted young age, high prednisolone dosage, and LMR at baseline. GC temporarily exacerbates but eventually improves arterial stiffness in rheumatic diseases. Particularly in young patients, GC may improve arterial stiffness by reducing inflammation. Therefore, the LMR before GC therapy in rheumatic diseases may be a potential predictor of arterial stiffness. Full article
(This article belongs to the Special Issue New Insights into Arterial Stiffness)
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